运动诱发电位用于鉴别诊断原发性帕金森病和多系统萎缩的临床研究

Motor evoked potentials for the differential diagnosis of idiopathic Parkinson's disease and multiple system atrophy

目的 :研究原发性帕金森病(Parkinson′s disease,PD)与多系统萎缩(multiple system atrophy,MSA)患者间的运动诱发电位(Motor evoked potentials,MEP)差异,探索其在两者鉴别诊断中的价值。方法:对12例MSA患者和12例性别、年龄匹配的初诊未服药原发性PD患者进行单脉冲经颅磁刺激-MEP检查,比较2组患者的MEP指标,通过绘制受试者工作特征曲线选取适用于鉴别诊断的指标。结果:运动阈值、MEP波幅和中枢运动传导时间(central motor conduction time,CMCT)在MSA与初诊原发性PD患者间差异无统计学意义(P>0.05),而MEP波形在2组间的差异存在统计学意义(P<0.05);MSA患者的MEP时长较初诊PD患者存在延长的趋势,但差异尚无统计学意义(P>0.05)。结论 :对MEP波形评级和MEP时长的检测有助于MSA与原发性PD间的鉴别诊断。

Objective： To investigate the difference in motor evoked potentials（MEP） between idiopathic Parkinson＇s disease（PD） and multiple system atrophy（MSA）, analyze its value for the differential diagnosis of PD and MSA. Methods：Single-pulse transcranial magnetic stimulation（s TMS）-MEP examination was performed in 12 patients with MSA and 12 sex and age matched idiopathic PD patients. MEP parameters were compared between the two groups of patients. Receiver operating characteristic curve was used to screen the parameters suitable for differential diagnosis. Results： The differences of motor threshold, MEP amplitude and central motor conduction time（CMCT） between idiopathic PD and MSA patients were not statistically significant（P〉 0.05）. The waveform of MEP differed significantly between idiopathic PD and MSA patients（P〈0.01）. The MEP duration showed a trend of prolonging in MSA patients than in idiopathic PD patients,but was not statistically significant（P〉0.05）. Conclusions： Both duration and waveform of MEP may help the differential diagnosis of MSA from idiopathic PD.